Identifying and distinguishing cases of parkinsonism and Parkinson's disease using ICD-9 CM codes and pharmacy data

被引:57
作者
Swarztrauber, K
Anau, J
Peters, D
机构
[1] Portland VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Portland, OR USA
[2] Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA
[3] Oregon Hlth Sci Univ, Gen Clin Res Ctr, Portland, OR 97201 USA
[4] Oregon Hlth Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA
关键词
sensitivity and specificity; prevalence; Parkinson's disease; ICD-9 CM codes; administrative data;
D O I
10.1002/mds.20479
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Administrative databases have the potential to assess quality and cost of care for parkinsonism and Parkinson's disease. However, the validity of findings is limited by our understanding of how cases are identified. Patient records listing International Classification of Diseases, Version 9, Clinical Modification (ICD-9 CM) codes for parkinsonism (n = 2,076) and dopaminergic medications (n = 2,798) were pulled from fiscal years 1999 to 2001 for patients in the Pacific Northwest Veterans Administration. Samples of these records (n = 397) and records without these ICD-9 CM codes (n = 500) were reviewed, and clinical data were extracted. The accuracy of administrative data to identify and distinguish between Parkinson's disease and parkinsonism was calculated. A total of 37.9% of parkinsonism cases were detected using pharmacy data and ICD-9 CM codes compared to 18.7% by using ICD-9 CM codes alone. The ICD-9 CM code for paralysis agitans (332.0) did not distinguish between probable Parkinson's disease and other causes of parkinsonism, whereas the ICD-9 CM code for degenerative basal ganglia disorder (333.0) predicted having secondary parkinsonism (odds ratio [OR] = 5.0) as well as dopa-responsiveness in patients without secondary parkinsonism (OR = 4.5). Administrative data are limited in the ability to identify parkinsonism. The ICD-9 CM code, 332.0, which is generally considered the code to identify Parkinson's disease, did not distinguish between parkinsonism and Parkinson's disease. © 2005 Movement Disorder Society.
引用
收藏
页码:964 / 970
页数:7
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